title: Video-assisted thoracoscopy as an option in the surgical treatment of chylothorax after cardiac surgery in children.
abstract: OBJECTIVE
  To evaluate the use of video-assisted thoracoscopy in the surgical treatment of chylothorax developed after the surgical correction of congenital heart disease in children.
  
  
  METHODS
  We reviewed the medical charts of 3,092 children who underwent surgery for congenital heart disease between February of 2002 and February of 2007 at the Heart Institute of the University of São Paulo School of Medicine Hospital das Clínicas, in São Paulo, Brazil.
  
  
  RESULTS
  Of the 3,092 children, 64 (2.2%) presented with chylothorax as a postoperative complication. In 50 (78.1%) of those patients, the clinical management was successful, whereas it failed in 14 (21.9%), all of whom were then submitted to thoracic duct ligation by video-assisted thoracoscopy. The thoracic duct ligation was successful in 12 patients (86%) but failed in 2. In the postoperative period, additional clinical measures, such as a low-fat diet and parenteral nutrition, were required in order to resolve those 2 cases. There was no surgical morbidity or mortality. Of the 14 patients who underwent thoracic duct ligation, 5 (35%) died due to cardiac or infectious complications.
  
  
  CONCLUSIONS
  Video-assisted thoracic duct ligation can be safely performed in patients with severe heart disease, and the outcomes are favorable.
authors.affiliation: Department of Cardiorespiratory Diseases, University of São Paulo School of Medicine, São Paulo, Brazil. paulo.fernandes@incor.usp.br
authors.forename: Paulo Manuel
authors.initials: PM
authors.lastname: Pego-Fernandes
authors.forename: Mauro Boldrini
authors.initials: MB
authors.lastname: Nascimbem
authors.forename: Otávio T
authors.initials: OT
authors.lastname: Ranzani
authors.forename: Mônica Satsuki
authors.initials: MS
authors.lastname: Shimoda
authors.forename: Rosângela
authors.initials: R
authors.lastname: Monteiro
authors.forename: Fábio Biscegli
authors.initials: FB
authors.lastname: Jatene
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D002916:Chylothorax / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*